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Improvements are needed to better measure mental health care quality

Research Activities, May 2010, No. 357

Although a great deal is known about the quality of health care services in the United States, there is a lack of information about the quality of mental health care and substance use services. A new study finds that quality initiatives are expanding in these health care fields. However, such activity remains uncoordinated and only focuses on limited areas. Despite such initiatives, no clear link has yet been established between these activities and an increase in quality improvement.

Researchers identified 36 initiatives that include mental health and substance use indicators into their quality measurements. Such efforts are being spearheaded by a variety of agencies, including Federal and State governments, professional organizations, and health plans. Once these programs were identified, the researchers conducted extensive reviews of each one to determine the exact indicators as well as their development and use. Some initiatives incorporated mental health and substance use indicators into larger programs, while others had unique, stand-alone initiatives for mental health. Some programs have already developed indicators but they have not yet been implemented in terms of data collection.

There is a lack of coordination among the various programs since there is no one group that oversees all of these efforts. As a result, significant gaps exist in the development of quality indicators that could be addressed by a central coordinating agency. The researchers also found poor database collection in mental health systems due to the lack of robust information technology in place.

To overcome these shortcomings, the researchers suggest the establishment of a coordinating agency to oversee indicator development and implementation. The study was supported in part by the Agency for Healthcare Research and Quality (HS16097) to Rutgers University's Center for Education and Research on Mental Health Therapeutics (CERT). For more information on the CERTs program, visit http://www.certs.hhs.gov.

See "Measuring mental healthcare quality in the United States: A review of initiatives," by Benjamin J. Herbstman, M.D., and Harold A. Pincus, M.D., in Current Opinion in Psychiatry 22, pp. 623-630, 2009.